Search

An abstract of the article "Endometrial surveillance in tamoxifen users: accuracy of ultrasound versus hysteroscopic investigation-observational longitudinal cohort study" by S. Gizzo and others is presented.

The article presents a study which analyzes the feasibility of performing an associated gynecological procedure following abdominal laparoscopic exploration with three-trocar access in patients with colorectal cancer and ovarian metastases. It evaluates the suitability of laparoscopic right colectomy for treating elderly patients. It states the emergence of laparoscopy with the three-trocar technique as a feasible alternative in managing gynecologic malignancies.

The article presents a case study of a 24-year-old nulliparous patient with a history of pelvic pain, pressure and evidence of a pelvic-perineal tumor. The patient underwent cystic tumor surgery and pathological examination revealed mature cystic teratoma. The article discusses dermoid cyst, mature and immature teratoma, and retroperitoneal teratomas.

The article presents a study of analyzing the correlation of papillomaviruses (HPV) deoxyribonucleic acid (DNA) and lymph nodes in cervical cancer patients. It mentions that 18 cervical cancer patients were included in the study and surgical procedure which consists of systematic pelvic lymphadenectomy, followed by radical hysterectomy is performed. It resulted to a non significance correlation between positive HPV DNA test in the cervix and lymph node metastasis.

The article presents a study of determining whether pelvic lymphadenectomy is useful in staging endometrial cancer, establish accurate prognosis and reduce postoperative therapy in patients. It states that 55 patients with endometrial cancer diagnosis are conducted for the study. It says that patients undergone surgery and showed different cases of cancer degree. It concludes that surgical dissection of the lymph node plays crucial role in covering this cancer.

The article presents an analysis of the incidence of port-site metastasis following laparoscopic surgery in borderline ovarian carcinoma (BOT) patients. It states that the research was conducted on 22 patients with a histological diagnosis of Stage 1 BOT. It suggests that ultraconcservative surgery is a safe method for preventing both abdominopelvic and scar metastasis.

Objective: The aim of this study was to measure plasmatic concentrations of vascular endothelial growth factor-A (VEGF-A) and placental growth factor (PIGF) in pregnant women, and to evaluate their relationship with age, hormonal status, gestational age, and different diseases of pregnancy., Methods: We selected a control group of 163 patients (96 fertile and 67 in menopause) and a group of 214 pregnant patients during the whole gestational period. VEGF-A and PlGF were assayed by ELISA and EIA methods, respectively. Statistical analysis was performed using the Mann-Whitney test., Results: The control group showed mean VEGF-A and PlGF values of 89.87 pg/ml and 10.22 pg/ml, respectively; PlGF showed the highest values in menopausal patients. The group of pregnant patients showed VEGF-A values of 27.05 pg/ml and PlGF values of 231.36 pg/ml respectively, with lower (for the VEGF-A) and higher (for the PlGF) statistical significance. These values were not influenced by biological age, but were related to gestational age: VEGF-A showed a decrease and PlGF an increase particularly after the 20th gestational week. PlGF showed a statistically significant decrease compared to physiological gestation in spontaneous and threatened abortions (p < 0.0001) and in ectopic pregnancies (p < 0.0001), an increase in ultrasound and CTG alterations (p < 0.05), and threatened premature delivery and uterine hypercontractility (p < 0.01); on the other hand VEGF-A showed a statistically significant increase in ectopic pregnancies (p < 0.05)., Conclusions: VEGF-A and PlGF may play a diagnostic and prognostic role in pregnancy. Further studies are required to better understand the meaning of variability of their values.

Objective: To validate transperineal ultrasound (US) in the assessment of urethrovesical junction hypermobility., Methods: In this prospective study carried out between 1999 and 2003 at a university medical centre we enrolled 100 women with genuine stress urinary incontinence (study group) and 50 continent women (control group). All women underwent the diagnostic protocol including urodynamic measurement and transperineal US scan using an abdominal semicircular 3.5 MHz linear array transducer. The position of the urethrovesical junction was described in relation to the inferior edge of the symphysis pubis by two parameters: the cephalocaudal and the ventrodorsal distance. The position and degree of urethrovesical junction descent during stress (3 consecutive coughs) were measured and the results compared between the groups. Classification performance was evaluated by sensitivity and specificity., Results: There was no significant difference in the horizontal plane of the urethrovesical junction at rest and in the backward displacement during stress between the groups. The downward displacement of the urethrovesical junction showed an average descent of 16.10 +/- 4.01 mm in the study group vs 7.92 +/- 2.85 mm in the control group; the difference between the groups was statistically significant (p = 0.001). Considering the 12 mm cut-off value of the descent, US evaluation had an 88% specificity, and a 92% sensitivity; the PPV and NPV were 96 % and 79 %, respectively., Conclusions: We found a significantly greater downward displacement of the urethrovesical junction during stress in women with stress urinary incontinence compared to healthy controls. We may conclude that transperineal US can accurately visualise a hypermobile urethrovesical junction.

Purpose of Investigation: To evaluate the correlation between fetal movement revealed in cardiotocography and fetal-neonatal well-being as well as to assess the value of cardiotocography in our clinical practice., Methods: Retrospective analysis of 3,805 pregnancies followed at Parma General Hospital. Exclusion criteria were cesarean section, preterm delivery, and stillbirth. We analyzed the predictive power of actography during the dilating and expulsive phases of labor by establishing a correlation between number of fetal movements and our neonatal indexes of well being, i.e., cardiotocographic score, Apgar index and neonatal pH value. Statistical tests used were Fisher's test, chi-square test (X2), Pearson correlation and Spearman Rho; p value was considered significant if it was less than 0.05., Results: We considered 2,389 vaginal deliveries. Analyzing the correlation between fetal movement and cardiotocographic score in the two different phases of labor, the comparison among subpopulations identified by different cardiotocograph scores revealed no statistical difference., Conclusion: Cardiotocography is reconfirmed as a good instrument to evaluate neonatal outcome, while actigraphy cannot be used alone to define fetal well-being, mainly due to the inability to standardize assessment of the actographic study.

Aim: Cervical intraepithelial neoplasia is most frequently in young women in reproductive age. Cold knife conization, laser ablation, laser conization and large loop excision are conservative methods of treatment to remove the transformation zone and preserve the cervical function. Previous studies have shown conflicting results on the outcomes of pregnancy following these therapies that might increase the risk of preterm delivery. The purpose of this study was to evaluate the outcome of pregnancy after conization and its role as predictive risk factor., Methods: A retrospective study was performed. The study group comprised 80 women who had a conization and that had a subsequent singleton pregnancy. Variables considered includes maternal excision date, surgery procedure, previous surgery treatments, time interval between excisional procedure and subsequent pregnancy; duration and week of pregnancy, mode of delivery, histological grading (no cervical intraepithelial neoplasia [CIN], CIN 1, CIN 2-3) and cone excised depth., Results: In group study 45 women underwent loop electrosurgical excision procedure (LEEP) conization, 32 cold knife conization and 3 laser CO2. The authors found 11 cases of cone tissue depth<1 cm, and remaining one>1 cm. Eight preterm delivery have been reported to data: 5 between 28 and 34 weeks, 2 lower than 28 weeks and 1 between 34 and 37 weeks., Conclusion: In these preliminary data the percentage of preterm birth appears as 10% and in range 6-15% evaluated for women not submitted to excisional procedures.

The purpose of this study was to analyze the outcome of vaginal and abdominal hysterectomy for the treatment of early-stage endometrial cancer in a selected group of elder patients. This retrospective study analyzed a total of 154 patients: 113 (group I) underwent vaginal surgery and 41 (group II) underwent laparotomy. In both groups, we investigated the following parameters: intra- and postoperative complications, mean operative time, mean hospital stay, disease-free survival (DFS), overall survival (OS), and time of local or retroperitoneal recurrence. Medically compromised patients were significantly more frequent in the vaginal surgery group (P = 0.005), and the operative duration in this group was significantly shorter (P = 0.01). Intra- and postoperative complications, along with local and distant recurrence, did not show a statistically significant difference in the two groups. Total survival in the two populations, 85% at 5 years, did not reach statistically significant difference either in terms of DFS or in terms of OS. Vaginal surgery compared to traditional abdominal approach is feasible also in patients with high surgical risk; it does not require general anesthesia, abolishes abdominal trauma correlated to laparotomy, and allows a quicker reprise of the bladder and rectal function; therefore, it achieves high eradication rates and low intra- and postoperative morbidity rates.